Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01029 | Date 11/09/2018 |
| Token No | SM/21-22/7897 18/12/2021 | Serial | 023 Last Visit: 15/11/2025 |
| Patient Name | Mrs. SHEFALI GHOSH | Contact No | 8017231081 |
| Address | 21/1 RAMKRISHNA BYE LANE CHATRA SERAMPORE , BAIDYABATI (M) | Age | 50 Years,10 Months,14 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||